Provider Demographics
NPI:1619590866
Name:LEWIS, KARLA SUE (LPCC)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:SUE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13311 VENDETTA WAY UNIT 303
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-7621
Mailing Address - Country:US
Mailing Address - Phone:592-291-3961
Mailing Address - Fax:
Practice Address - Street 1:9616 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-3473
Practice Address - Country:US
Practice Address - Phone:502-479-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-22
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY262852101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health